Healthcare Provider Details

I. General information

NPI: 1457606659
Provider Name (Legal Business Name): EARBY HOME INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 07/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26310 CARLYSLE ST
INKSTER MI
48141-2651
US

IV. Provider business mailing address

26310 CARLYSLE ST
INKSTER MI
48141-2651
US

V. Phone/Fax

Practice location:
  • Phone: 313-363-8822
  • Fax:
Mailing address:
  • Phone: 313-363-8822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALANA EARBY SMITH
Title or Position: OWNER
Credential:
Phone: 313-363-8822